Haridwar: Doctors at Max Super Speciality Hospital, Dehradun, successfully treated a rare and complex case involving a 58-year-old man from Kotdwar, whose critical, life-threatening condition was ultimately traced to a large tumour in the rectum, compounded by a separate, sizeable tumour involving his right kidney.
Mr. Dinesh Singh Negi, a known case of diabetes and hypertension,had been admitted to another hospital for nearly 25 days in the Intensive Care Unit (ICU) with persistent low blood pressure requiring continuous medications, intravenous fluids, and electrolyte replacement, along with profuse mucinous diarrhea that led to severe dehydration, nutritional depletion, and repeated electrolyte imbalance. Despite extensive evaluation, the underlying cause of his rapidly deteriorating condition could not be established, and owing to the extremely high surgical risk, operative intervention was deferred.
Seeking better treatment options, the patient’s family decided to consult Max Super Speciality Hospital, Dehradun, known for its clinical expertise in handling such complex cases. They approached Dr. Saurabh Tiwari, Senior Consultant – Surgical Oncology,known for his expertise in managing complex colorectal conditions. After a detailed clinical assessment, Dr. Tiwari suspected that the rectal tumour itself was responsible for the patient’s critical illness. A multidisciplinary team initiated aggressive nutritional optimisationwith a high-protein diet, intensive electrolyte correction, and supportive care to prepare him for surgery.
After five days of meticulous pre-operative optimisation, the patient underwent a highly complex surgery to remove the rectal tumourdespite the significant operative risk. Remarkably, within just two to three days following surgery, his condition began improving rapidly. His blood pressure stabilised without the need for supportive medications, the excessive diarrhoea stopped completely, electrolyte levels normalised, and he was shifted out of the ICU to the ward. The patient was discharged within a week in a stable condition.
Following rehabilitation and nutritional recovery over the following months, the patient regained sufficient strength to undergo a second major surgery for the removal of the large tumour involving his right kidney. The procedure was successfully performed, and the patient recovered well without major complications, and he was discharged after eight days in a stable condition. Today, the patient has resumed his normal routine and is leading a healthy life with his family in his native village.
Speaking about the case, Dr. Saurabh Tiwari, Senior Consultant – Surgical Oncology, Max Super Speciality Hospital, Dehradun, said, “This was not just a challenging surgical case but also a diagnostic challenge. The patient’s prolonged critical illness was being driven by the rectal tumour itself, and identifying this was crucial to planning the treatment. Rather than attempting both surgeries together, we adopted a staged approach by first addressing the condition responsible for his critical state. Once he recovered and regained strength, we successfully removed the kidney tumour as well. Cases like these highlight the importance of timely diagnosis, careful surgical planning, and multidisciplinary collaboration in achieving favorable outcomes, even in patients considered extremely high risk.”
The successful management of this rare case underscores Max Super Speciality Hospital, Dehradun’s expertise in managing complex gastrointestinal and tumour-related conditions through advanced surgical expertise, evidence-based clinical decision-making, and coordinated multidisciplinary care, enabling patients with challenging and high-risk diseases to achieve successful outcomes.
